A case of histoplasmosis Report 1. Cinical, mycological and pathological observations

In our country it has been believed that there is no histoplasmosis here in Japan. However, from the above clinical signs, radiological characteristics, laboratory tests, pathological and mycological examinations, and experimental findings, we believe this is the first case of histoplasmosis in Japan.</p

PD-1とVEGFR2の同時阻害による相乗的抗腫瘍効果

Recent basic and clinical studies have shown that the programmed death ligand (PD-L)/PD-1 pathway has a significant role in tumour immunity, and its blockade has a therapeutic potential against several human cancers. We hypothesized that anti-angiogeneic treatment might augment the efficacy of PD-1 blockade. To this end, we evaluated combining the blockade of PD-1 and vascular endothelial growth factor receptor 2 (VEGFR2) in a murine cancer model using Colon-26 adenocarcinoma. Interestingly, simultaneous treatment with anti-PD-1 and anti-VEGFR2 monoclonal antibodies (mAbs) inhibited tumour growth synergistically in vivo without overt toxicity. Blocking VEGFR2 inhibited tumour neovascularization significantly, as demonstrated by the reduced number of microvessels, while PD-1 blockade had no impact on tumour angiogenesis. PD-1 blockade might promote T cell infiltration into tumours and significantly enhanced local immune activation, as shown by the up-regulation of several proinflammatory cytokine expressions. Importantly, VEGFR2 blockade did not interfere with T cell infiltration and immunological activation induced by PD-1 blockade. In conclusion, simultaneous blockade of PD-1 and VEGFR2 induced a synergistic in-vivo anti-tumour effect, possibly through different mechanisms that might not be mutually exclusive. This unique therapeutic strategy may hold significant promise for future clinical application.博士（医学）・甲第600号・平成25年5月29日発行元の猶予期間終了の後、本文を登録予定（2014.06

Wintertime Nocturnal Temperature Distribution Based on Spatially High Density Observation Data in the Tokyo Metropolitan Area under Clear Sky and Weak Wind Conditions

Tokyo -one of the largest cities in the world- exhibits intensive urban land use, urban sprawl, and high anthropogenic heat exhaustion, which produce characteristic urban temperature distributions. Typical features of the nocturnal temperature distribution from November to February under conditions of clear skies and weak winds were analyzed for the Tokyo metropolitanwardarea using data from spatially high-density observations from the Automated Meteorological Data Acquisition System(AMeDAS) of the Japan Meteorological Agency(JMA), municipal air pollution monitoring systems, and Extended-METROS from 2006/2007 to 2009/2010. To analyze the structure of temperature distributions in the Tokyo-ward area, hourly temperature data at 124 stations were interpolated into grid points with 1-km intervals. When high temperatures in central Tokyo were expressed as a difference in AMeDAS temperature between central Tokyo(Otemachi) and an average of four points outside the Tokyoward area, the weather conditions most strongly affecting this temperature differ ence at 06:00 Japan Standard Time(JST), prior to sunrise, were cloud amount followed by wind speed. The temperature difference at night under clear-sky and weak-wind conditions (average cloud amount of 2/10 or less and aver age wind speed of 3 m/s or less) generally showed an abrupt increase during the several hours before and after sunset followed by a gradual increase, reaching maximum levels before sunrise(06:00 JST). When the temperature difference before sunrise was large, the difference would evidently increase even after midnight; however, if this difference was small, it would tend to decrease after midnight.The high temperatures in the metropolitan area were concentrated throughout the nightnear the southern area of Chuo ward. In particular, it is noted th at several zones of steep horizontal temperature gradients were detected in the metropolitan-ward area. These zones (e.g.starting from the southern part of Saitama Prefecture, it appeared through the border between Nerima and Itabashi wards, Toshima, Shinjuku, and the area stretching from western Setagaya to the southwest) appeared during the period several hours before and after sunset, and gradually became more noticeable near sunrise. The distribution of temperature-decrease rate around sunset also showed steep horizontal gradient zones, which corresponded to regions exhibiting steep horizontal temperature gradient zones between the inner city and outer area

Comparison of CBF between pCASL and SPECT

Purpose: We compared the regional cerebral blood flow (rCBF) obtained by pulsed continuous arterial spin labeling (pCASL) and iodine-123-N-isopropyl-p-iodoamphetamine (IMP) single photon emission computed tomography (SPECT) using 3-dimensional stereotactic region-of-interest (ROI) software for automated definition of ROIs in anatomic regions of the brain. Methods: Thirteen patients with cerebrovascular occlusive disease and three with transient ischemic attacks underwent pCASL and IMP SPECT imaging. We compared rCBF values of each anatomic region and calculated the correlation coefficients between pCASL and IMP SPECT. We also calculated the asymmetry index (AI) using ROIs in contralateral regions of the hemispheres. Results: The rCBF values calculated from pCASL and IMP SPECT were comparable in most segments, but rCBF in the thalamus (P < 0.0001) and hippocampus (P = 0.0006) was significantly higher measured by pCASL than IMP SPECT. The correlation of rCBF between pCASL and IMP SPECT in the affected hemisphere (r = 0.50) tended to be lower than that in the normal hemisphere (r = 0.59), but not significantly different (P = 0.25). Moreover, there was a fixed bias for underestimation of rCBF by pCASL (P = 0.0047) in the affected hemisphere. The calculated AI showed a significant relationship between methods (r = 0.79, P < 0.0001). Conclusion: The rCBF obtained by pCASL had positive relationships with IMP SPECT. However, it should be considered that pCASL tends to have a weak relationship with IMP SPECT in some normal regions and regions affected by cerebrovascular occlusive disease

Temporal increase in muscle cross-sectional area as an acute effect of resistance exercise in resistance-trained and untrained individuals

The purpose of this study was to compare the temporal increase in muscle cross-sectional area (CSA) as the acute response of resistance exercise (RE) between resistance-trained and untrained groups, and investigate the factors that affect the muscle CSA. Resistance-trained (n = 14) and untrained (n = 14) subjects performed four kinds of triceps brachii RE. Muscle CSA and intracellular hydration (IH), were measured prior to and 5-, 30-, and 60-minute after RE. Pearson's correlation coefficient was calculated to clarify the relationships among percent increases in muscle CSA and IH, area under the Oyx-Hb curve, blood lactate concentration, and % maximum voluntary contraction (MVC)-root-mean-square (RMS) of electromyogram (EMG). At 5-minute after RE, muscle CSA increased significantly to 120.2 ± 6.3% in the resistance-trained group and 105.5 ± 2.3% in the untrained group (p < 0.01). However, neither group showed a significant difference between the values before and 30-minute after RE. In the resistance-trained group, there was a significant increase in IH at 5-minute post-RH (p < 0.01), and correlations were found between percent increases in muscle CSA and IH (r = 0.70, p < 0.01), area under the Oxy-Hb curve (r = 0.77, p < 0.01), and % MVC-RMS of EMG (r = 0.72, p < 0.01). The findings of this study suggest that measurements of muscle CSA in studies of muscle hypertrophy should be performed 30-minute or more after the last resistance exercise session, and muscle pump exercises should be conducted just before participation in bodybuilding, and physique contests

Research Activities in the Department of Physical Therapy

[Introduction] It is already fifty years since the Japanese law of physical therapists and occupational therapists has been effective. The physical therapist is referred by the law as "the professionals who implements the physical therapy to persons with disabilities under the prescription of medical doctors". In fifty years, however, the target of physical therapy has been significantly expanded. The subject for physical therapy now includes the patients in acute disease just after the surgical operation in addition to those in rehabilitation stage. In other words, the physical therapy is now recognized as the indispensable intervention to the subject with acute as well as chronic disorders. On the other hand, due to a rapid transition of the society into the aged society, prevention of diseases, and decline of activity capacity due to the aging have become major issues for the physical therapy

Efficacy of prosultiamine treatment in patients with human T lymphotropic virus type I-associated myelopathy/tropical spastic paraparesis: results from an open-label clinical trial

Background: Human T lymphotropic virus type I (HTLV-I)-associated myelopathy/tropical spastic paraparesis (HAM/TSP) is a chronic myelopathy characterized by motor dysfunction of the lower extremities and urinary disturbance. Immunomodulatory treatments are the main strategy for HAM/TSP, but several issues are associated with long-term treatment. We conducted a clinical trial with prosultiamine (which has apoptotic activity against HTLV-I-infected cells) as a novel therapy in HAM/TSP patients. Methods: We enrolled 24 HAM/TSP patients in this open-label clinical trial. Prosultiamine (300 mg, orally) was administered once daily for 12 weeks. We monitored changes in the motor function of the lower extremities and urinary function as well as copy numbers of the HTLV-I provirus in peripheral blood mononuclear cells (PBMCs). Results: Improvement in the motor function of the lower extremities based on a reduction in spasticity (for example, decrease in time required for walking and descending a flight of stairs) was observed. In an urodynamic study (UDS), bladder capacity and detrusor pressure and then maximum flow rate increased significantly. Detrusor overactivity and detrusor-sphincter dyssynergia improved in 68.8% and 45.5% of patients observed at pretreatment, respectively. Improvement in UDS corresponded with improvements in the score of nocturia-quality of life questionnaire. HTLV-I proviral copy numbers in PBMCs decreased significantly (approximately 15.4%) compared with pretreatment levels.Conclusions: These data suggest that prosultiamine can safely improve motor dysfunction of the lower extremities and urinary disturbance as well as reduce HTLV-I provirus levels in peripheral blood. It therefore has potential as a new therapeutic tool for HAM/TSP patients.Trial registration: University Hospital Medical Information Network Clinical Trials Registry (UMIN-CTR) number, UMIN000005969. Please see related commentary: http://www.biomedcentral.com/1741-7015/11/183

Heat transfer characteristics of a pipe-laminar jet impinging on a moving hot solid

This study experimentally investigated the hydrodynamics and heat transfer characteristics of a circular water jet impinging on a moving hot metal sheet as fundamental research on pipe-laminar cooling. The circular jet was issued from a 5-mm-diameter pipe nozzle. A 0.3-mm-thick sheet made of stainless steel was adopted as the test sheet. In the experiment, the liquid flow formed by the jet impingement was observed by flash photography, and the temperature profile on the underside of the moving sheet was measured by infrared thermography. The initial temperature of the moving solid was varied from 100°C to 500°C. The mean velocity at the nozzle exit ranged between 0.4 m/s and 1.2 m/s. The moving velocity of the solid was set to less than or equal to 1.5 m/s. The estimated heat flux profile on the cooled surface was found to be strongly dependent on the initial temperature of the sheet. When the initial temperature of the sheet was relatively low, a bow-shaped high heat flux region appeared in the upstream of the jet impact point. At higher temperatures, the heat flux area existed only in the jet impact regions. The heat flux increased with increasing initial sheet temperature, reached peak values, and then decreased drastically. The sharp decrease in the heat flux, which was due to the formation of a vapor layer, was influenced by the jet velocity and/or the sheet velocity